Individual
JESSICA DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2950 CHIPPEWA ST, BATON ROUGE, LA 70805-8126
(225) 456-4203
Mailing address
2950 CHIPPEWA ST, BATON ROUGE, LA 70805-8126
(225) 456-4203
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
LA
Enumeration date
10/14/2020
Last updated
10/14/2020
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